Findings of Upstate-led Clinical Trial Provide New Treatment Options

Aclinical trial led by Upstate Medical University radiation oncologist Jeffrey Bogart, MD ’89, may have major implications for the treatment of small cell lung cancer.

The study, “High-Dose Once-Daily Thoracic Radiotherapy in Limited-Stage Small-Cell Lung Cancer,” was published January 9 in the Journal of Clinical Oncology. About 30,000 people are diagnosed with small cell lung cancer each year, which accounts for about 15 to 20 percent of all lung cancer patients.

The Bogart-led clinical trial was the largest trial in limited-stage small cell lung cancer ever performed, including more than 700 patients throughout the United States from 2008 to 2019. Results showed similar outcomes and long-term survival in patients treated with once-a-day versus twice-a-day radiotherapy. Previously, the twice-a-day regime was recommended as standard, but only 15 percent of patients nationwide opted for twice-daily radiation treatments due to the challenge of coming in for appointments two times each day.

Bogart says that a higher dose of radiation given once a day over seven weeks showed no statistical difference in survival rates than the twice-a-day regimen. He says technology today is much more advanced than it was 30 years ago, allowing very focused treatment with image guidance that can produce targeted radiation, resulting with fewer side effects.

Bogart says the study’s publication in the Journal of Clinical Oncology has the capacity to change care.

“It is one of the top cancer journals in the world, with high visibility and oncology physicians will see the study outcomes and it will impact the patterns of care,” he says. “It allows patients a real choice, understanding that there may be some differences in side effects, or their ability to complete the longer therapy, but now they know both regimens can be associated with good outcomes,” he said.

Bogart says the next step in assessing the benefit of this treatment protocol is to look at subpopulations, for example, based on gender or age.

“The goal over time is to get away from the onesize-fits-all approach to now offer better, more personalized therapy,” Bogart says. “The findings of this study move us in that direction. Our findings need to be confirmed in subsequent trials, but it can provide a lot of information to help design future trials as well.”